Vaginal bleeding during pregnancy can occur frequently in the first trimester of pregnancy, and may not be a sign of problems.
However, bleeding that occurs in the second and third trimester of pregnancy can often be a sign of a possible complication.
If you have any bleeding during your pregnancy, with or without pain, it’s very important to visit your doctor.
Is bleeding during pregnancy normal?
It’s common to have light bleeding or ‘spotting’ without pain before 12 weeks. This isn’t often serious, but you should contact your doctor, midwife to be checked, just in case.
Possible causes of first trimester bleeding include:
Implantation bleeding:
You may experience some normal spotting within the first six to 12 days after you conceive as the fertilized egg implants itself in the lining of the uterus. Some women don’t realize they are pregnant because they mistake this bleeding for a light period. Usually the bleeding is very light and lasts from a few hours to a few days.
Cervical changes:
Pregnancy hormones can cause changes to the cervix, which can sometimes cause bleeding. The cervix gets an increased blood supply and becomes softer. This can cause some bleeding after sex (known as post-coital bleeding).
Infection:
A vaginal infection may cause spontaneous vaginal bleeding. The bleeding may be accompanied by an abnormal vaginal discharge.
Miscarriage:
Bleeding can be a sign of miscarriage, but does not mean that miscarriage is imminent. Studies show that anywhere from 20-30% of women experience some degree of bleeding in early pregnancy. Approximately half of pregnant women who bleed do not have miscarriages. Approximately 15-20% of all pregnancies result in a miscarriage, and the majority occur during the first 12 weeks.
Signs of Miscarriage include:
Vaginal bleeding, cramping pain felt low in the stomach (stronger than menstrual cramps) and tissue passing through the vagina.
Ectopic pregnancy:
In an ectopic pregnancy, the fertilized embryo implants outside of the uterus, usually in the fallopian tube. If the embryo keeps growing, it can cause the fallopian tube to burst, which can be life-threatening to the mother. Although ectopic pregnancy is potentially dangerous, it only occurs in about 2% of pregnancies.
Other symptoms of ectopic pregnancy are strong cramps or pain in the lower abdomen, and lightheadedness.
Molar pregnancy:
A molar pregnancy is when a foetus doesn’t form properly in the womb and a baby doesn’t develop. Symptoms can include:
Bleeding, severe morning sickness and an unusually swollen tummy.
When should I see a doctor about bleeding?
Any time you notice bleeding during any stage of pregnancy, it is appropriate to call your doctor. It is particularly important to seek medical attention if the bleeding is heavy (like a menstrual period) or accompanied by pain or cramping.
